Everolimus before capecitabine?

Hi wiziz,

My oncologist likes to cycle between chemo and endocrine treatments. I think his approach is to try to avoid endocrine resistance as long as possible. I went from an AI/Ibrance to Capecitabine, then to Faslodex (layering in Verzenio a couple of years later, back to Capecitabine, and then on to other chemos that have unfortunately failed. I’m now back on Capecitabine for the third time.

Capecitabine is a very tolerable treatment with few side effects, at least in my case. The most challenging is the hand and foot syndrome which causes dryness, pain and cracking of the skin on your hands and feet. However, it’s very manageable with frequent use of moisturizer. I find this time I have more fatigue and brain fog but the effects are cumulative so I guess that’s not surprising. I suspect my MO will adjust my dose for the next cycle.

I would recommend trying Capecitabine over going on Exemestane and Everolimus. Some ladies were on Capecitabine for years (in my case I have issues with toxicity to the marrow which is why my MO did not want me to stay on it). Everolimus, in particular, is a really tough drug to manage. My MO mentioned that few patients can tolerate it (I believe mouth sores are a major issue).

I hope this is helpful and you are able to land on an effective treatment

Whizz- when ibrance and fulvastrant failed I went on Everolimus and exemestane. I consulted with UCSF and read a lot of material and that was the advice from everyone. it worked for 10 months and I found it easy to take. after it failed I went on Capecitabine and have been on it for 2 years- it is starting to fail now also.. My MO said that I would cycle through them both and the order wasn't that important- some people don't tolerate A/A easily especially if you have blood sugar problems- and some people don't tolerate Capcitabine well.

It is nice to have options

Wendy-

I did really well on Everolimus- was on 10 mg per day. my labs were good, my hair was luscious I did do the recommended swishing with a steroid mouthwash to prevent mouth sores for 2 months and then stopped (this is a hope Rugo study if you want to check it out) I had no mouth sores. lots of symptoms I had from Ibrance went away. I think I was tired first 2 months. it worked for 10 months. my MO did say that most of her patients have more side effects than I had- you can lower the dose as well. I took it with aromasin.